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Basis of Presentation and Summary of Significant Accounting Policies - Allowance for Doubtful Accounts (Details) - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Allowance for Doubtful Accounts Receivable [Roll Forward]      
Beginning balance $ 34,042 $ 28,109 $ 1,498
Provision for bad debt expense 54,558 54,074 37,407
Deductions and other (48,835) (48,141) (10,796)
Ending balance $ 39,765 $ 34,042 $ 28,109